<ol id="sections">
    <li class="section">
        <div class="dp-content">
            <div id="my-account">
                <div id="appointment-body">
                    <div id="header-appointment-details">
                        <?php include_partial("progress_bar", array("isSignIn" => true, "step" => "one")) ?>
                        <div id="appointment-left">
                            <?php include_partial("appointment_details", array("doctorTimeSlot" => $doctorTimeSlot)) ?>
                        </div>
                        <div id="appointment-right">                            
                            <form id="step-one-form" action="<?php echo url_for('/appointment-book-now-step-one/' . $doctorTimeSlotId . '/' . $appointmentReasonId) ?>" method="post">
                                <?php echo $form->renderHiddenFields(false) ?>
                                <div class="imperative">Whom is this appointment for?</div>
                                <?php include_partial("select_field", array("form" => $form, "field" => "is_for_yourself")) ?>
                                <div class="imperative">Specify the reason for your visit!</div>
                                <?php include_partial("select_field", array("form" => $form, "field" => "appointment_reason_id")) ?>
                                <div class="imperative">Have you visited this doctor before?</div>
                                <?php include_partial("select_field", array("form" => $form, "field" => "is_new_doctor")) ?>
                                <div class="imperative">Do you intend to use your medical insurance?</div>
                                <?php include_partial("select_field", array("form" => $form, "field" => "is_using_insurance")) ?>
                                <div class="row">
                                    <ul>
                                        <li>
                                            <button id="submit" type="submit" class="blue-button-30">Proceed</button>
                                        </li>
                                    </ul>
                                </div>
                            </form>
                        </div>
                        <div class="clear"></div>
                    </div>
                </div>
                <?php include_partial("common/social_media") ?>
            </div>
        </div>
    </li>
</ol>